Researchers in Minnesota have raised safety concerns over the common but technically illegal sale of secondhand CPAP devices on Craigslist.
In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription.
The researchers’ concerns about the sale of used devices are outlined in a study published in the medical journal JAMA Internal Medicine. The researchers are from the University of St. Thomas, University of Minnesota, and Minneapolis Veterans Affairs Health Care System.
Once a week the research team monitored online advertisements for secondhand CPAP devices on Craigslist.org in 18 US cities and areas over a one-month period.
During that time they found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only five of the advertisements mentioned anything about the legal requirements of a prescription and 61% of the devices included a used mask without information about its age or how it was cleaned.
CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory.
The study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners.
In addition to concerns about the hygiene of secondhand devices and masks, the study said that a “secondhand device may deliver a low pressure that is ineffective or a high pressure that is excessive.”
“Our results raise concerns about the safety of these devices and how effective these secondhand devices are,” says one of the study’s three co-authors, Roxanne Prichard, PhD, an associate professor of psychology and neuroscience at the University of St. Thomas and scientific director of St. Thomas’ Center for College Sleep, in a release.
The study’s co-authors are Ken Kunisaki, MD, MS, an associate professor at the University of Minnesota and Minneapolis Veterans Affairs Health Care System, and Marisa Peine, who recently received her bachelor’s degree in neuroscience at St. Thomas.
The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device.
“We recognize that for patients with obstructive sleep apnea, but who do not have health insurance to pay for a CPAP, these secondhand devices represent a less expensive alternative to purchasing a new device,” Prichard says.
The study noted an alternative to the Craigslist consumer-to-consumer method of online sales, and that is the American Sleep Apnea Association’s CPAP Assistance Program.
This program collects used CPAP devices in good condition, cleans them, reprograms them based on the patient’s prescription, ships the device and a new mask to the patient or her or his doctor, and charges $100.
“We believe that this CPAP Assistance Program provides a nice alternative to consumer-to-consumer sales,” Kunisaki says. “Similar programs should be developed to improve access to CPAP for the growing number of patients being diagnosed with obstructive sleep apnea, but who have limited resources to afford treatment.”
The researchers have no affiliation with the American Sleep Apnea Association.
Talk about looking for an answer for a problem that does not exist. You do know it is very easy to check and change settings don’t you? You do know that air is not recirculated within the CPAP device, don’t you? You do know that hospitals reuse CPAP on different patients and they do not go through a sterilization process, only a wipe down of the outside and provide new hose and masks, right?
How much government money did you get for this completely useless study?
You’re starting with a false assumption that the pressure is fixed and will be whatever was it was originally set at.
Most people buying a used machine know enough to be able to reset the pressure. I would guess that a majority are being bought as back-up machines since they wouldn’t be covered by insurance or Medicare. Clinician manuals are available freely online and numerous forums exist to provide information and advice.
Whoever authorized the funding for this “study” should be fired.
Did the researchers determine WHY the sellers were selling the devices and WHY the buyers were buying them?
If not, this study is meaningless because the answers are so obvious.
Please allow me to list a few thoughts as a long-time CPAP user.
The utter failure in the education of new CPAP users is one of the reasons they’re being sold by those who have given up on their therapy.
In too many cases, the new users are just handed their equipment at the DME shop and told to figure it out for themselves. They’re not given instructions on how to get into the setup menus to make changes because the manufacturers are afraid of lawsuits. However, the setup/clinical information has been abundantly available on the Internet for over a decade.
In many instances, the titrated pressure settings are not correct after the person begins using the equipment in their home environment. After suffering with the therapy for awhile, the user gives up. In the case of APAP settings, the pressure ranges are too wide and are not therapeutic or effective for the user. More failure and frustrations and they give up.
Fully data-capable machines are not always given to the users. The manufacturers should cease manufacturing data-less machines immediately. Narrowing the product line would actually result in increased profits. In truth, most of the differences between the machines are in the internal programming and not the hardware.
Another problem has been software access by the users. If they DO have a data-capable machine, they have been told that the software is too complicated, too hard to use, the user wouldn’t understand it, they’re not supposed to know about the data (only the doctors should see the data) and on and on. If the users can’t monitor or tweak their own therapy, they get frustrated and give up.
So, after the new user is given their data-less machine or one they can’t cope with (because of lack of education by the DME), they get frustrated with their therapy and give up. The DMEs don’t care about how effective the user’s therapy is, they just want to see “compliance” so they can get paid by the insurance provider. Many doctors are the same way.
In some cases, the user realizes that they were given a data-less machine and have managed to find a better one which collects data. So, they sell their dumb machines to recoup some of the costs.
Some sellers seem to have access to machines that “slipped out the backdoor” of some of the DME shops. May be rare situations, but it has happened. In some cases, the DME shops have closed up and their inventory is disbursed in various ways. Then, they get sold to needy folks.
Some sellers have acquired newer machines and sell their older ones which may have been sitting in their closets and the user didn’t think to keep them for a backup/spare machine.
Many of the machines have been found in garage/yard sales, 2nd hand shops, estate sales, or other auction/sales venues.
So, there are a few of the numerous reasons why these machines are being sold.
Who is buying them?
As noted in the article, some potential users who have no insurance or lousy insurance and/or find it’s cheaper to go out-of-pocket buying this stuff.
Some buyers already have machines and are looking for additional ones……data-capable, backup/spare machines.
Many in that category probably already have a prescription/order and their acquisition is essentially “legal”.
Having a data-less CPAP machine is like a person with Diabetes having a glucose meter that doesn’t record their blood sugar. Or, insulin syringes with no markings on them to determine the dosages. People with Diabetes are instructed on the testing and dosing of their medications. CPAP machines ONLY blow AIR…….but the manufacturers have done their best to try to prevent the users from monitoring their own therapy……instead of “educating” the users. ABSURD!!!
How stupid it is to have a study done to find out the most obvious reasons!!! They’re staring you right in the faces.